| Cassidy Medical Group - Csb | |
|
2562 State St Ste D Carlsbad CA 92008-1663 | |
| (760) 729-7186 | |
| (760) 729-2753 |
| Full Name | Cassidy Medical Group - Csb |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2562 State St Ste D, Carlsbad, California |
| Authorized Official Name and Position | Judith M Krueger (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7606305487 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cassidy Medical Group - Csb 2562 State St Ste D Carlsbad CA 92008-1663 Ph: (760) 729-7186 | Cassidy Medical Group - Csb 2562 State St Ste D Carlsbad CA 92008-1663 Ph: (760) 729-7186 |
| NPI Number | 1457427668 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 03/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457427668 | NPI | - | NPPES |
| 3023 | Other | CA | NEIC SITE ID, NSF BA0-7 |
| GR0060603 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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